BC senior's public health study honored by CDC

The Centers for Disease Control and Prevention has named Boston College senior Sebastian Cota as one of seven recipients of the 2023 Williams-Hutchins Health Equity Award, which recognizes outstanding projects by undergraduates in the CDC John R. Lewis Summer Public Health Scholars Program.

Cota’s award-winning study compared the prices of four food staples at grocery stores and bodegas in Upper Manhattan to evaluate barriers to food access in the historically Dominican neighborhood of Washington Heights, with the goal of preventing food-related chronic diseases like diabetes, obesity, and hypertension. He conducted it while enrolled in the Summer Public Health Scholars Program at Columbia University’s Mailman School of Public Health, one of seven Lewis Scholars programs around the country.

“In New York City, there are bodegas on every block, but supermarkets are not as common,” said Cota, a student in BC's Morrissey College of Arts and Sciences. “I wanted to get a sense of where structural inequalities prevent people from accessing quality and affordable fresh food, which impacts health outcomes.”

Hispanic populations in the United States are at risk when it comes to food-related chronic diseases. According to 2018 data from the U.S. Office of Minority Health, Hispanic adults in the U.S. are 70 percent more likely than non-Hispanic white adults to be diagnosed with diabetes and 1.2 times more likely to be obese. Access to healthy and nutritious food—and the time and money to buy and prepare it—is crucial to preventing these diseases.

“The most effective way to treat these diseases at scale is through prevention,” Cota explained. “To make sure patients can live their healthiest lives, we need to look at both the affordability and quality of the food near them.”

During his summer program at Columbia, Cota completed a six-week internship at the School of Nursing’s Center for Community-Engaged Health Informatics and Data Science, located near the part of Washington Heights known as “Little Dominican Republic.” When designing his Lewis Scholars project, Cota chose to focus on the prices of four staples of Dominican cooking: eggs, milk, cooking oil, and mayonnaise. He recorded the prices of these items at 38 bodegas and 40 supermarkets and compared the results using an independent samples t-test (a statistical test that is used to compare the means of two groups).

On average, he found, groceries were significantly pricier at bodegas than supermarkets, which tended to be in more affluent areas. These results are telling, but “just a starting point,” said Cota.

“Anybody can highlight a disparity, but we can’t just blame individual bodega owners and walk away,” he said. “The important thing is thinking about the next steps to making people’s lives better.”

In Cota’s presentation, which he gave at the Lewis Scholars Summer Showcase and Expo in July, he focused on several possible directions that future research could take.

“We need to do more qualitative analysis to hear the stories of both community residents and the bodega owners,” Cota said. “What are the barriers to providing affordable groceries, and how can we use what owners tell us to advocate for policy change? What do community members need, and can we respond by creating more food pantries or free cooking classes?”

He fully intends to take some of these next steps himself. After graduation next May, he plans to attend a public health master’s program and medical school before returning to his hometown of Los Angeles to practice as a physician in the community where he grew up.

“In my career, I want to combine public health with my practice as a provider,” he said. “If you’re working in a neighborhood that’s medically underserved or in a food desert, you need to understand the context to provide effective care.”

Cota, who is Mexican American, grew up in southeast LA and is the first in his family to attend college. His interest in public health emerged from his own experiences seeing members of his community struggle with food insecurity and linguistic, social, and financial barriers that affected their health and access to care. In high school, while volunteering at the county hospital, he witnessed these disparities daily in one of the nation’s busiest emergency rooms.

“Patients would regularly wait 10 to 15 hours to be seen and then be unable to afford basic care or insulin,” Cota recalled. “Seeing that level of injustice, both in the hospital and in my community, was deeply frustrating. I just felt that it was not right.”

This sense of injustice sparked a mission. Before he even enrolled at Boston College, Cota reached out to Professor of Biology Philip J. Landrigan, M.D., director of the Global Public Health and the Common Good program, about the possibility of studying public health. At the time, there was no such major at BC, but Cota worked with Landrigan to create an independent course of study and became one of the first students to enroll in the Global Public Health and the Common Good major this fall.

In addition to winning the CDC Williams-Hutchins Health Equity Award—named for the first African American man and woman to complete 30-year careers in the U.S. Public Health Service—Cota’s Washington Heights study also won first place in the pre-med category at the 2023 Latino Medical Student Association National Conference in September.

“It truly is a blessing to have these opportunities,” Cota said of this second honor, which came as a surprise. “Only six percent of U.S. physicians are Latinos, and it’s so important and inspiring to meet peers and mentors who can guide me and share their experiences with me.”